Sinus Surgery (Patient Instructions)
Rahul K. Shah, MD, FAAP, FACS
Dr. Shah obtained his BA/MD from Boston University and completed his Otolaryngology residency at Tufts University followed by a fellowship in Pediatric Otolaryngology at Children's Hospital Boston at Harvard University. After fellowship, he joined the faculty of Children's National Medical Center in 2006. Dr. Shah is an active clinical researcher and has received numerous awards for his research.
Charles Patrick Davis, MD, PhD
Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.
- Sinus surgery facts
- What is sinus surgery?
- What are the risks and complications of sinus surgery?
- What happens before sinus surgery?
- What takes place the day of sinus surgery?
- What happens during sinus surgery?
- What happens after sinus surgery?
- How long will it take to recover from sinus surgery?
- General instructions and follow-up care for sinus surgery
- When should I notify the doctor of any postsurgery complications?
- Self-Care and prevention after sinus surgery
- Find a local Ear, Nose, & Throat Doctor in your town
Sinus surgery facts
- Traditional sinus surgery removes diseased or obstructive sinus tissue resulting in improved natural sinus drainage. Post-operative care is as important as the sinus surgery.
- Balloon sinuplasty or sinus ostial dilation surgery is a newer method to address sinus disease. It involves expanding the natural drainage openings of the sinus passages. It is an approved, safe procedure that may be done in the operating room or office setting for some patients.
- There are many risks and complications of sinus surgery; failure to resolve infection, recurrence of the original sinus problem, bleeding, chronic nasal drainage, failure to resolve all original sinus problems, damage to the eyes or base of the skull, pain, reduction or loss of sense of smell or taste, or the need for additional surgery and medical consultations.
- If the sinus surgery is in the operatiung room with general anesthesia:
- Prior to surgery, the patient needs to refrain from food and drink for 8 hours, have no fever, and arrange for someone to bring the patient to and from the hospital
- On the day of surgery, the patient should have all paperwork and meet the anesthesiologist; the patient should only take the medication approved by the surgeon and anesthesiologist.
- The surgery may take several hours.
- After sinus surgery, most patients can go home accompanied by a friend or relative; bed rest with the head elevated is recommended along with an ice pack wrapped in a towel to stop any bleeding that commonly occurs.
- Recovery may take about 3 to 5 days; patients should take their prescribed medications and avoid any strenuous activities until cleared to do so by the surgeon.
- Follow-up care is critical for recovery; keep all appointments and follow instructions in regard removing nasal packing and especially instructions on nasal irrigation (many surgeons request patients to remain in the area for 3 weeks after surgery in case any problems develop).
- Notify the surgeon for excessive bleeding, fever greater than 101.5 F (38.6 C) that persists even with Tylenol use, sharp pain or headache not responsive to medications, increased swelling of nose or eyes and thin clear fluid draining from the nose.
- Self-care and prevention of complications include maximizing moisture in the nose (moisturize frequently), moisturizing sprays such as "Ocean Spray" are useful), avoid allergens, colds and the flu (make sure flu shots are up-to-date).
- If the sinus surgery is in the office-based setting or the balloon sinuplasty method is used, the surgeon and clinical team may have you refrain from eating and drinking if sedation is used. In some cases, the procedure may be done under local anesthesia only.
- Recovery on the day of balloon sinuplasty is usually quicker than with general anesthesia. The post-operative recovery will also take several days, include nasal irrigation, and include follow-up in the office.
- It is important to note that balloon sinuplasty has not been shown to be superior to traditional sinus surgery regarding the long-term outcome for patients and the elimination or recurrence of disease.
What is sinus surgery?
Traditional sinus surgery involves the precise removal of diseased sinus tissue with improvement in the natural drainage channels by the creation of a pathway for infected material to drain from the sinus cavities. In most situations, the surgeon will employ endoscopic techniques which allow better and more precise visualization without the need for external incisions. As a result, there is less swelling, bleeding, and discomfort, and a faster recovery from sinus surgery.
Sinus surgery, unlike other types of surgery where a diseased part or organ is removed, involves the re-routing of existing sinus pathways in addition to removal of diseased tissue. It cannot be emphasized more strongly that post-operative care is as equally important as the surgery itself. One of the most common causes of failure of this procedure is poor post-operative care and follow-up. The doctor can only do so much. It is up to the patient to share in the responsibility of caring for this chronic illness. The following instructions are designed to help patients recover from sinus surgery as easily as possible and to prevent complications. It is very important that patients read these instructions or those provided by their surgeon and follow them carefully.
The following information is provided to help individuals prepare for sinus surgery and to help them understand more clearly the associated beliefs, risks, and complications of sinus surgery. However, people are encouraged to ask their doctor any questions to help them better understand the procedure.
What are the risks and complications of sinus surgery?
The following complications of sinus surgery have been reported in the medical literature. This list is not meant to be inclusive of every possible complication. It is here for patient information only - not to make patients overly concerned - but to make them aware and more knowledgeable concerning potential aspects of sinus surgery. The surgeon will review the risks and benefits of the surgery when obtaining consent for the operation, and will be able to discuss the chance of these complications with respect to an individual's potential risks of surgery at that time.
- Failure to resolve the sinus infections or recurrence of sinus problems and/or polyps.
- Bleeding. In very rare situations, a need for blood products or a blood transfusion may be required. Patients have the right, should they choose, to have autologous (using their own stored blood) or designated donor blood prepared in advance in case an emergency transfusion is necessary. Patients are encouraged to consult with their doctor regarding these issues if they are interested.
- Chronic nasal drainage or excessive dryness or crusting of the nose.
- Need for further and more aggressive surgery.
- Need for allergy evaluation, treatments, or environmental controls. Surgery is not a cure for or a substitute for good allergy control or treatment.
- Failure to improve or resolve concurrent respiratory illness such as, but not limited to, asthma, bronchitis, or cough.
- Failure to resolve associated "sinus or nasal" headaches. The exact cause of headaches can be difficult to determine and may have many different causes that are not sinus-related.
- The patient or physician may require consultation with another specialist such as a neurologist.
- Damage to the eye and its associated structures.
- Damage to the skull base with resultant meningitis, brain abscess, or leakage of spinal fluid.
- Permanent numbness of the upper teeth, palate, or face.
- Nasal obstruction due to failure to control infection or polyps.
- Prolonged pain, impaired healing, and the need for hospitalization.
- Failure to restore or worsening of the sense of smell or taste.
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